Free at the Point of Delivery 2
But what cost at the point of taxation?
A letter to Today on Wednesday, written in response to another one regarding healthcare spending, has this suggestion:
"We could perhaps work towards increasing personal taxes to cover Government healthcare cost and make healthcare free for every citizen."
That got me thinking: what would it cost to provide free healthcare for all citizens?
It was a few days before I could find this article (which we might discuss perhaps another time) with the statistics I was looking for. Again, I remind all that I failed statistics in med school, so take the bits that follow with a pinch of salt…
Now figure 3 gives you the total national health expenditure, and breakdown into Government and Private expenditure.
The figure for the year 2000 is about S$4.7 billion, with the Private expenditure amounting to about S$3.5 billion.
Now the Government part is already being paid for by the taxes we now pay, so if we want to provide free healthcare, we need to raise another S$3.5 billion or so per year (assuming we don’t want to disturb the rest of the Budget).
With a population of about 3.5 million (counting citizens only), that works out to about S$1000 per capita per year. And that’s over and above what you already pay in taxes.
So for a family of four with one working adult and two children, that’s S$4000 per year. If this working adult makes just enough to not have to pay income tax (S$1800 per month?), that’s 18.5% of his income each year.
Another way of looking at it is as a monthly rate of S$83 per person. Doesn’t sound like much, but to spend that amount of money on healthcare, you will have to do one of the following:
1. See a doctor at the polyclinic once a week
2. See a private GP once a fortnight
3. Visit the A&E once a month
4. Have a hernia operation once a quarter
5. Have your appendix taken out every six months
6. Have your gallbladder taken out every year
7. Go for a heart bypass every 2 years
8. Have a baby once every 3 years
9. Be on long-term medication that cost you S$2.75 per day.
If you are already doing one or more of the above now, then you would probably want to lobby for free healthcare.
If you are not, then you probably wouldn’t. But if you WERE paying S$1000 a year, wouldn’t you be doing all of the above?
I used to think that people would not consume more healthcare than they need to, but I soon realised how wrong I was after starting work.
Why take a cab to the GP when you can get an ambulance and be seen at the A&E for free?
Why NOT have an X-ray for that ache in your leg after running the 2.4km yesterday, since it is free? Better yet, gimme an MRI!
I am sure you can think of other things to add to the list.
Net result? The total healthcare expenditure will soon exceed S$4.7 billion, and your per capita taxation will soon be more than S$1000.
So let’s all be careful what we wish for…